Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Recorded changes
82,180 on record
Recorded policy changes, newest first| Recorded | Payer | Policy | Change |
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| Sep 30, 2026 | Molina Healthcare | Incarceration Diagnosis CodePayerPolicy · MOLINA-TX-MARKETPLACE-INCARCERATION-DIAGNOSIS-CODE | Retired |
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| Sep 30, 2026 | Molina Healthcare | ICD-10 First Listed Diagnosis Coding PolicyPayerPolicy · MOLINA-TX-MARKETPLACE-CODING-ICD-10-FIRST-LISTED-DIAGNOSIS-CODING-POLICY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Hydrolyzed Enteral Formula DiagnosisPayerPolicy · MOLINA-TX-MARKETPLACE-HYDROLYZED-ENTERAL-FORMULA-DIAGNOSIS | Retired |
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| Sep 30, 2026 | Molina Healthcare | Co Surgeon Team Surgeon ProfessionalPayerPolicy · MOLINA-TX-MARKETPLACE-CO-SURGEON-TEAM-SURGEON-PROFESSIONAL | Retired |
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| Sep 30, 2026 | Molina Healthcare | Advanced Beneficiary Notice ABN Modifiers GA GX GY GZPayerPolicy · MOLINA-TX-MARKETPLACE-ADVANCED-BENEFICIARY-NOTICE-ABN-MODIFIERS-GA-GX | Retired |
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| Sep 30, 2026 | Molina Healthcare | Add-on CodingPayerPolicy · MOLINA-TX-MARKETPLACE-CODING-ADD-ON-CODING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Image Guided Radiation TherapyPayerPolicy · MOLINA-SC-MEDICARE-RADIOLOGY-IMAGE-GUIDED-RADIATION-THERAPY | Retired |
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| Sep 30, 2026 | Molina Healthcare | CT Computed Tomography of the Abdomen and PelvisPayerPolicy · MOLINA-SC-MEDICARE-RADIOLOGY-CT-COMPUTED-TOMOGRAPHY-OF-THE-ABDOMEN-AND-PELVIS | Retired |
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| Sep 30, 2026 | Molina Healthcare | ESRD Billing for J0406 or J0606 with Modifier AXPayerPolicy · MOLINA-SC-MEDICARE-ESRD-ESRD-BILLING-FOR-J0406-OR-J0606-WITH-MODIFIER-AX | Retired |
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| Sep 30, 2026 | Molina Healthcare | Recovery Policy for Revenue to CPT Code ReviewPayerPolicy · MOLINA-SC-MEDICARE-ADMINISTRATIVE-RECOVERY-POLICY-FOR-REVENUE-TO-CPT-CODE-REVIEW | Retired |
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| Sep 30, 2026 | Molina Healthcare | Multiple Procedure Payment ReductionPayerPolicy · MOLINA-SC-MEDICARE-ADMINISTRATIVE-MULTIPLE-PROCEDURE-PAYMENT-REDUCTION | Retired |
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| Sep 30, 2026 | Molina Healthcare | Annual Wellness Visit sooner than 11 months following Initial IPPEPayerPolicy · MOLINA-SC-MEDICARE-ADMINISTRATIVE-ANNUAL-WELLNESS-VISIT-SOONER-THAN-11-MONTHS | Retired |
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| Sep 30, 2026 | Molina Healthcare | After Hours and Weekend Care ProfessionalPayerPolicy · MOLINA-SC-MEDICARE-ADMINISTRATIVE-AFTER-HOURS-AND-WEEKEND-CARE-PROFESSIONAL | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2099 Intracellular Micronutrient AnalysisPayerPolicy · MOLINA-SC-MEDICARE-LAB-G2099-INTRACELLULAR-MICRONUTRIENT-ANALYSIS | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2150 Biomarkers for Myocardial Infarction and Chronic Heart FailurePayerPolicy · MOLINA-SC-MEDICARE-LAB-G2150-BIOMARKERS-FOR-MYOCARDIAL-INFARCTION-AND | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2164 Parathyroid Hormone Phosphorus Calcium and Magnesium TestingPayerPolicy · MOLINA-SC-MEDICARE-LAB-G2164-PARATHYROID-HORMONE-PHOSPHORUS-CALCIUM-AND | Retired |
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| Sep 30, 2026 | Molina Healthcare | G2174 Coronavirus Testing in the Outpatient SettingPayerPolicy · MOLINA-SC-MEDICARE-LAB-G2174-CORONAVIRUS-TESTING-IN-THE-OUTPATIENT | Retired |
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| Sep 30, 2026 | Molina Healthcare | M2116 Human Immunodeficiency Virus HIVPayerPolicy · MOLINA-SC-MEDICARE-LAB-M2116-HUMAN-IMMUNODEFICIENCY-VIRUS-HIV | Retired |
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| Sep 30, 2026 | Molina Healthcare | Specimen Validity TestingPayerPolicy · MOLINA-SC-MEDICARE-LAB-SPECIMEN-VALIDITY-TESTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Packaged and conditionally packaged lab servicesPayerPolicy · MOLINA-SC-MEDICARE-LAB-PACKAGED-AND-CONDITIONALLY-PACKAGED-LAB-SERVICES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Labs Overlapping with FacilityPayerPolicy · MOLINA-SC-MEDICARE-LAB-LABS-OVERLAPPING-WITH-FACILITY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Split-Night-Sleep-StudyPayerPolicy · MOLINA-SC-MEDICARE-CLINICAL-SPLIT-NIGHT-SLEEP-STUDY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Optum EDC Analyzer - Facility ER E&M Leveling PrepaymentPayerPolicy · MOLINA-SC-MEDICARE-CLINICAL-OPTUM-EDC-ANALYZER-FACILITY-ER-E-M-LEVELING | Retired |
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| Sep 30, 2026 | Molina Healthcare | HospicePayerPolicy · MOLINA-SC-MEDICARE-CLINICAL-HOSPICE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Facility Emergency Department Evaluation and Management levelingPayerPolicy · MOLINA-SC-MEDICARE-CLINICAL-FACILITY-EMERGENCY-DEPARTMENT-EVALUATION-AND | Retired |
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| Sep 30, 2026 | Molina Healthcare | Unspecified Codes in an Inpatient SettingPayerPolicy · MOLINA-SC-MEDICARE-UNSPECIFIED-CODES-IN-AN-INPATIENT-SETTING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Unlisted CodingPayerPolicy · MOLINA-SC-MEDICARE-CODING-UNLISTED-CODING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Therapy Modifier CodingPayerPolicy · MOLINA-SC-MEDICARE-CODING-THERAPY-MODIFIER-CODING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Reduced Services and Discontinued ProceduresPayerPolicy · MOLINA-SC-MEDICARE-REDUCED-SERVICES-AND-DISCONTINUED-PROCEDURES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Podiatric Q ModifiersPayerPolicy · MOLINA-SC-MEDICARE-PODIATRIC-Q-MODIFIERS | Retired |
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| Sep 30, 2026 | Molina Healthcare | Member PCP as Attending Provider in a ER Facility SettingPayerPolicy · MOLINA-SC-MEDICARE-MEMBER-PCP-AS-ATTENDING-PROVIDER-IN-A-ER-FACILITY | Retired |
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| Sep 30, 2026 | Molina Healthcare | ICD-10 SpecificityPayerPolicy · MOLINA-SC-MEDICARE-ICD-10-SPECIFICITY | Retired |
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| Sep 30, 2026 | Molina Healthcare | ICD-10 First Listed Diagnosis Coding PolicyPayerPolicy · MOLINA-SC-MEDICARE-CODING-ICD-10-FIRST-LISTED-DIAGNOSIS-CODING-POLICY | Retired |
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| Sep 30, 2026 | Molina Healthcare | Facility Bilateralor Anatomical Modifier UsePayerPolicy · MOLINA-SC-MEDICARE-FACILITY-BILATERALOR-ANATOMICAL-MODIFIER-USE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Discontinued ProceduresPayerPolicy · MOLINA-SC-MEDICARE-DISCONTINUED-PROCEDURES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Diagnosis Code Y65 XXPayerPolicy · MOLINA-SC-MEDICARE-DIAGNOSIS-CODE-Y65-XX | Retired |
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| Sep 30, 2026 | Molina Healthcare | Co Surgeon Team Surgeon ProfessionalPayerPolicy · MOLINA-SC-MEDICARE-CO-SURGEON-TEAM-SURGEON-PROFESSIONAL | Retired |
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| Sep 30, 2026 | Molina Healthcare | CMS Replacement CodesPayerPolicy · MOLINA-SC-MEDICARE-CMS-REPLACEMENT-CODES | Retired |
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| Sep 30, 2026 | Molina Healthcare | Authorized Pain Management Services with a Claim Modifier MismatchPayerPolicy · MOLINA-SC-MARKETPLACE-PHARMACY-AUTHORIZED-PAIN-MANAGEMENT-SERVICES-WITH-A-CLAIM | Retired |
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| Sep 30, 2026 | Molina Healthcare | CT Computed Tomography of the Abdomen and PelvisPayerPolicy · MOLINA-SC-MARKETPLACE-RADIOLOGY-CT-COMPUTED-TOMOGRAPHY-OF-THE-ABDOMEN-AND-PELVIS | Retired |
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| Sep 30, 2026 | Molina Healthcare | Ambulatory Echocardiograph MonitoringPayerPolicy · MOLINA-SC-MARKETPLACE-RADIOLOGY-AMBULATORY-ECHOCARDIOGRAPH-MONITORING | Retired |
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| Sep 30, 2026 | Molina Healthcare | Ambulance ModifierPayerPolicy · MOLINA-SC-MARKETPLACE-TRANSPORTATION-AMBULANCE-MODIFIER | Retired |
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| Sep 30, 2026 | Molina Healthcare | ESRD 90999 No Modifier Weekly and Monthly LimitsPayerPolicy · MOLINA-SC-MARKETPLACE-ESRD-ESRD-90999-NO-MODIFIER-WEEKLY-AND-MONTHLY-LIMITS | Retired |
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| Sep 30, 2026 | Molina Healthcare | ESRD Billing for J0406 or J0606 with Modifier AXPayerPolicy · MOLINA-SC-MARKETPLACE-ESRD-ESRD-BILLING-FOR-J0406-OR-J0606-WITH-MODIFIER-AX | Retired |
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| Sep 30, 2026 | Molina Healthcare | DME Rental Vs PurchasePayerPolicy · MOLINA-SC-MARKETPLACE-DME-DME-RENTAL-VS-PURCHASE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Semiprivate Vs Private RoomPayerPolicy · MOLINA-SC-MARKETPLACE-ADMINISTRATIVE-SEMIPRIVATE-VS-PRIVATE-ROOM | Retired |
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| Sep 30, 2026 | Molina Healthcare | Recovery Policy Variable Discount Payments for ProvidersPayerPolicy · MOLINA-SC-MARKETPLACE-ADMINISTRATIVE-RECOVERY-POLICY-VARIABLE-DISCOUNT-PAYMENTS-FOR | Retired |
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| Sep 30, 2026 | Molina Healthcare | Recovery Policy for Revenue to CPT Code ReviewPayerPolicy · MOLINA-SC-MARKETPLACE-ADMINISTRATIVE-RECOVERY-POLICY-FOR-REVENUE-TO-CPT-CODE-REVIEW | Retired |
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| Sep 30, 2026 | Molina Healthcare | Recovery Policy for CPT to CPT CodePayerPolicy · MOLINA-SC-MARKETPLACE-ADMINISTRATIVE-RECOVERY-POLICY-FOR-CPT-TO-CPT-CODE | Retired |
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| Sep 30, 2026 | Molina Healthcare | Multiple Procedure Payment ReductionPayerPolicy · MOLINA-SC-MARKETPLACE-ADMINISTRATIVE-MULTIPLE-PROCEDURE-PAYMENT-REDUCTION | Retired |
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